Medical Education最新文献

{"title":"A longitudinal curriculum combining medical education, anatomy and ultrasound.","authors":"Anthony Nguyen, Elena Stark, William Shyy, Alan Chiem","doi":"10.1111/medu.15737","DOIUrl":"https://doi.org/10.1111/medu.15737","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching routine person-centred practice in medical education through medicines optimisation: A realist review.","authors":"Richard Bodington, Joanne Reeve, David Hepburn, Matthew Morgan, Paul E S Crampton","doi":"10.1111/medu.15727","DOIUrl":"https://doi.org/10.1111/medu.15727","url":null,"abstract":"<p><strong>Background: </strong>Multimorbid patients are not well served by a narrow biomedical disease-focused approach to health care. The situation calls for a paradigm shift in health care practice towards an interpretive, person-centred model. Medical educators urgently need to teach medical students how to integrate biomedical and interpretive approaches to illness but practical pedagogy in the field is lacking. Medicines optimisation (MO), which encompasses deprescribing, provides an everyday case study of a curriculum theme requiring the everyday integration of potentially dissonant illness perspectives to achieve learning applicable for clinical practice. By clarifying 'what works, for whom, under what circumstances, how and why' in MO education, we can better support the practical integration of dissonant illness perspectives in wider medical education.</p><p><strong>Method: </strong>A realist review was conducted in keeping with the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines identifying MO educational interventions trialled in undergraduate medical curricula globally and developing a programme theory (PT) illuminating the contexts, mechanisms and outcomes related to these interventions. Databases including Medline, Embase, Scopus and ERIC were searched. Inclusion criteria focused on undergraduate MO/deprescribing educational interventions and were iteratively adjusted for PT development.</p><p><strong>Results: </strong>Analysis of 56 documents highlighted four key components needed to integrate biomedical and interpretive illness perspectives: the role of stakeholder perceptions influencing prioritisation, resource allocation and engagement; meaningful inclusion into summative assessments; learners' appreciation of their professional role and responsibility; and alignment of programmes with workplace and institutional culture.</p><p><strong>Discussion: </strong>Our PT uniquely unpacks the black-box of undergraduate MO educational programmes and will be developed through subsequent evaluations. The PT provides insight for educators in clinical pharmacology and more widely as an exemplar of education requiring the practical integration of biomedical and interpretive illness perspectives required of modern practitioners.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between daily wellness behaviours and outcomes among medical students: A longitudinal nightly survey study.","authors":"Ankrish Milne, Alexandra Novelli, Carly Watson, Hakeem Yousef, William E Copeland, Leigh Ann Holterman, Lee Rosen, Yang Bai, Azilee Curl, Samuel Pasqualoni, Stephen Kirby, Xi Xi Halvorson-Phelan, James Hudziak","doi":"10.1111/medu.15724","DOIUrl":"https://doi.org/10.1111/medu.15724","url":null,"abstract":"<p><strong>Background: </strong>Previous research on medical student wellbeing has examined single wellness-related behaviours in isolation and relied on cross-sectional or pre-post surveys. The objective of this study was to use daily, app-based surveys to examine which wellness behaviours have the strongest associations with positive wellbeing in a medical student sample.</p><p><strong>Methods: </strong>A total of 213 medical students willing to participate were enrolled in this study during summer 2021. Participants completed nightly surveys on a novel smartphone app, which assessed eight wellness-related indicators (e.g., social interaction, sleep, exercise, nutrition) and four wellbeing outcomes (mood, focus, stress, overall wellbeing). Both same-day and next-day associations between indicators and outcomes were assessed.</p><p><strong>Results: </strong>Of the 213 participants enrolled, 116 completed more than 50% of nightly surveys, providing 7043 observations over 3 months. All wellbeing outcomes varied significantly within a given week, with peak stress and lowest mood and wellbeing levels at the midweek mark. In cross-sectional/same-day analyses, quality of social interactions, sleep quality and nutrition had the strongest associations with same-day outcomes. The cumulative impact of engaging in these wellness indicators was equal to a one standard deviation higher score on same-day wellbeing and mood outcomes. In longitudinal/next-day analyses, quality of social interactions and sleep quality had the strongest associations with outcomes, but the associations were generally modest compared to same-day results.</p><p><strong>Conclusions: </strong>A specific set of daily wellness behaviours may have substantial associations with mood, wellbeing and other positive outcomes, but the carryover of these behaviours to the next day is limited. Medical schools should test interventions that target multiple wellness activities and find ways to prompt these behaviours daily.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should medical teachers spend more time modelling or coaching students? A dual eye-tracking and randomised controlled study on peer instruction in sonography.","authors":"Dogus Darici, Hendrik Ohlenburg, Lukas Jürgensen, Cihan Papan, Anita Robitzsch, Markus Missler, Bertrand Schneider","doi":"10.1111/medu.15725","DOIUrl":"https://doi.org/10.1111/medu.15725","url":null,"abstract":"<p><strong>Background: </strong>When first introducing medical procedures, instructors must decide how much of their limited time must be allocated between modelling (demonstrate and explain) and coaching (scaffold and support) students. Given the time constraints in clinical routine, it is currently unknown which relative proportion of modelling versus coaching is more efficient for procedural learning.</p><p><strong>Methods: </strong>We randomly assigned 73 students without prior knowledge to either an extended modelling (EM) or an extended coaching (EC) group for an emergency sonography training. In the EM group, medical teachers demonstrated a routine examination explaining their thought process, while also providing some coaching. In the EC group, students trained more independently with consistent teacher support, with less emphasis on modelling. We used dual mobile eye-tracking and voice recording to objectify the teacher-student interactions and applied a comprehensive assessment to understand which learning domains improved under which condition.</p><p><strong>Results: </strong>On post-tests, the EC group outperformed the EM group by 12% in interpreting dynamic sonographic imagery (p = 0.014). They completed the ultrasound examinations 7% faster (p = 0.050). There was no statistical difference between the two groups in interpreting static sonographic imagery (p = 0.322) nor in practical scores (p = 0.062). Contrary to expectations, there were no differences between the groups in terms of eye movement metrics that explained the performance effects. However, two behavioural variables were positively related with learning outcomes across both groups: the percentage of joint visual attention between teacher and student (β = 0.316, p < 0.001) and the number of words spoken during the training (β = 0.175, p = 0.004).</p><p><strong>Conclusion: </strong>This study provides empirical evidence that EC may be particularly effective when introducing new procedural medical skills. In learning complex procedures, direct sensorimotor experience with guided support appears more advantageous than extended observation. These findings suggest that medical educators should give students more opportunities for supervised hands-on practice rather than relying primarily on demonstration-based teaching.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Hofstede's framework to explore surgical cultures and their impact on female surgeons.","authors":"Gozie Offiah, Susie J Schofield, Charlotte E Rees","doi":"10.1111/medu.15726","DOIUrl":"https://doi.org/10.1111/medu.15726","url":null,"abstract":"<p><strong>Context: </strong>Workplace diversity improves outcomes, yet surgical cultures have long been identified as a deterrent for women considering surgical careers due to male-dominated traditions. Our study explores the impact of surgical cultures and their influence on gender through the analytical lens of Hofstede's cultural dimensions framework. We apply this in a novel way to gain deeper insights into how masculinity and other cultural dimensions intersect.</p><p><strong>Methods: </strong>For this qualitative study-part of a larger study exploring gender in surgery-we conducted semi-structured interviews with 29 female surgeons, 18 male and female colleagues of female surgeons (surgeons, anaesthetists, nurses and physician associates) and 13 patients of female surgeons. We analysed the data using framework analysis, with surgical cultures being identified as a central theme. We drew on Hofstede's cultural dimensions theory to deeply interrogate how cultural dimensions intersect to shape the surgical environment, thereby disadvantaging women.</p><p><strong>Results: </strong>Competition, achievement and heroism associated with masculinity were thought to be pervasive and hindered progression, particularly for female surgeons. Unequal power distributions were reported to lead to female surgeons working harder to earn respect. Female overseas doctors narrated the challenges of being respected by male colleagues from their own collectivist countries. Long-standing 'old boys' club' traditions associated with uncertainty avoidance were thought to maintain the gendered status quo. Long-term orientation and restraint were reported to impact female surgeons with career breaks. However, our analysis indicated novel interplays between masculinity and the other five cultural dimensions, with some dimensions overlapping (e.g., long-term orientation and restraint) and others contradicting (e.g., power distance and collectivist values).</p><p><strong>Conclusion: </strong>This study, drawing on Hofstede's cultural dimensions, illustrates the complexity of interacting cultural dimensions, serving to maintain inequities for female surgeons. We therefore provide recommendations for multiple interventions to enable surgical culture change, based on these intersecting six cultural dimensions.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the hierarchy: Systems thinking to progress interprofessional workplace learning.","authors":"Karanjeet Chauhan, Rhiarna Gridley, Fiona Kent","doi":"10.1111/medu.15730","DOIUrl":"https://doi.org/10.1111/medu.15730","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Playing with our 'self' in medicine: A discourse analysis of 'self' exploration.","authors":"Rabia Khan","doi":"10.1111/medu.15720","DOIUrl":"10.1111/medu.15720","url":null,"abstract":"<p><p>[26 May 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pick me, pick me: Proposed indicators for collaboration in medical education research.","authors":"Joanna Tai, Rola Ajjawi, Gabrielle Maria Finn","doi":"10.1111/medu.15691","DOIUrl":"10.1111/medu.15691","url":null,"abstract":"<p><p>[26 May 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magic 8 Balls and psychics: Results of a National Survey of programme directors on their novel recruitment strategies in a post-grade era.","authors":"Laura Greisman, Sydney Katz","doi":"10.1111/medu.15694","DOIUrl":"10.1111/medu.15694","url":null,"abstract":"<p><p>[26 May 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost in learning.","authors":"Janet Grant, Kadambari Dharanipragada, Mohammed Ahmed Rashid","doi":"10.1111/medu.15689","DOIUrl":"10.1111/medu.15689","url":null,"abstract":"<p><p>[26 May 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}